Hindawi Publishing Corporation Stem Cells International Volume 2012, Article ID 931902, 12 pages doi:10.1155/2012/931902 Clinical Study Bilateral Transplantation of Allogenic Adult Human Bone Marrow-Derived Mesenchymal Stem Cells into the Subventricular Zone of Parkinson’s Disease: A Pilot Clinical Study N. K. Venkataramana, 1 Rakhi Pal, 2 Shailesh A. V. Rao, 1 Arun L. Naik, 1 Majahar Jan, 2 Rahul Nair, 2 C. C. Sanjeev, 1 Ravindra B. Kamble, 1 D. P. Murthy, 1 and Krishna Chaitanya 1 1 Advanced Neuro Science Institute, BGS Global Hospital, Bangalore 560060, India 2 ANSA Research Foundation, Indiranagar, Bangalore 560038, India Correspondence should be addressed to N. K. Venkataramana, drnkvr@gmail.com Received 31 August 2011; Accepted 1 November 2011 Academic Editor: Francesco Dazzi Copyright © 2012 N. K. Venkataramana et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The progress of PD and its related disorders cannot be prevented with the medications available. In this study, we recruited 8 PD and 4 PD plus patients between 5 to 15 years after diagnosis. All patients received BM-MSCs bilaterally into the SVZ and were followed up for 12 months. PD patients after therapy reported a mean improvement of 17.92% during “on” and 31.21% during “off ” period on the UPDRS scoring system. None of the patients increased their medication during the follow-up period. Sub- jectively, the patients reported clarity in speech, reduction in tremors, rigidity, and freezing attacks. The results correlated with the duration of the disease. Those patients transplanted in the early stages of the disease (less than 5 years) showed more improvement and no further disease progression than the later stages (11–15 years). However, the PD plus patients did not show any change in their clinical status after stem cell transplantation. This study demonstrates the safety of adult allogenic human BM-MSCs trans- planted into the SVZ of the brain and its efficacy in early-stage PD patients. 1. Introduction Shaking Palsy (Paralysis Agitans) or Parkinson’s disease (PD) was originally described by James Parkinson in 1817 as “Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; with a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured” [1]. Ever since the first description, scientists have pursued the causes and treatment of the disease. It is a chronic neu- rodegenerative disorder due to selective loss of dopaminergic neurons in the Substantia Nigra (SN) and the presence of proteinaceous inclusions known as Lewy bodies [2]. PD is recognized as one of the most common neurologic disorders, affecting approximately 15% of individuals older than 60 years. Between the ages of 75 and 84, that percentage may rise to almost 30%. The causes of idiopathic Parkinson-disease (IPD) are be- lieved to be a combination of genetic and environmental fac- tors. Recent studies indicate that the pathogenesis includes a cascade of molecular and cellular events, oxidative stress, and release of reactive oxygen species (ROS), apoptosis, dysfunc- tioning of mitochondria and of the protein degrading system. Even immune-mediated mechanisms are being suggested for the progression and to explain the drug resistance that hap- pens with time [2, 3]. The cardinal symptoms for PD are bradykinesia, rigidity, tremor, and instability which can be treated with dopamine replacement drugs. However, these drugs are unable to inter- rupt the progress of the disease and are ineffective against the disabling gait freezing, postural instability, lethargy, and lack of facial expressions. Also, over time there are drug-induced motor system complications; hence, it is suggested to delay the therapy till it significantly limits the patient’s activities of daily living [4].